Provider Demographics
NPI:1093561805
Name:DAIL, ALLISON MARIE
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:DAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6169 S BALSAM WAY STE 250
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3063
Mailing Address - Country:US
Mailing Address - Phone:303-933-4555
Mailing Address - Fax:
Practice Address - Street 1:6169 S BALSAM WAY STE 250
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3063
Practice Address - Country:US
Practice Address - Phone:303-933-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0009249363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant